Quote from DebbieIRRN
I am in great need of some policy/procedures regarding patients who take metformin and receive IV contrast, either CT or angiogram. What is the practice now on patients stopping the metformin and restarting? I guess here we are suppose to just 'know' what to do. I know they have to be off of it but what about restarting it and what if this is a brittle diabetic or someome who has been running hi, do they still take it, stop taking? Any ssistance would be great. Thanks and Happy New Year to Everyone!!!
It is standard protocol to hold any medication containing Metformin for 24 hours prior to a procedure requiring IV or IT iodine contrast media. The medication should be held also the day of the procedure and for an additional 48 hours post procedure. These patients should be given an order for a bun/creatinine lab to be drawn 48 hours post exam. In some facilities, the lab work is reviewed prior to the patient restarting their medication. There are a total of 19 medications containing metformin which I have listed for your reference. Any of these medications can cause a drug-drug interaction with the contrast media.
Glucophage, Metformin, Glucophage XR, Avandamet, Glucovance, Actoplus Met, Glumetza, Riomet, Metaglip, Fortamet, Glucovan, Alti-Metformin, Apo-Metformin,Glycon, Novo-Metformin, Nu-Metformin, PMS-Metformin, Rhoxalmetformin FC, and Rho-Metformin